Dickson Kwamena Sekyi, Ahinkorah Bright Opoku
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana.
Arch Public Health. 2017 Jul 3;75:30. doi: 10.1186/s13690-017-0197-5. eCollection 2017.
Tobacco use is one of the leading causes of preventable deaths and has become a significant public health issue. Previous studies have paid less attention to tobacco use and socio-economic equalities among men in developing countries. This study examines the relationship between tobacco use and socio-economic inequalities among men in Ghana and Lesotho.
The study made use of data from the 2014 Demographic and Health Survey (DHS) from Ghana, and Lesotho. Binary logistic regression was employed to examine the associations between socio-economic inequality characteristics of respondents and tobacco use.
The results showed that the prevalence of tobacco use was high in Lesotho (47.9%) as compared to that of Ghana (6.3%). Tobacco use was generally high across all age groups in Lesotho and in contrast, it was relatively low across all ages in Ghana. A statistically significant association was found between all the socio-economic variables and tobacco use in both countries. The prevalence of tobacco use was smaller in age group 15-24 years compared to the age groups 25-34 years and 35-59 years in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR's in Ghana are respectively 5.3 (95% CI: 3.29-8.59) and 9.7 (95% CI: 6.20-15.06), compared to respectively 1.7 (95% CI: 1.32-2.11) and 1.7 (95% CI: 1.36-2.12). Smoking prevalence was smaller in men with higher level of education compared to men with no education in both Ghana and Lesotho, although the association was weaker in Ghana. The AOR in Ghana is 0.1 (95% CI: (0.02-0.11), compared to 0.2 (95% Cl: (0.17-0.30). The prevalence of tobacco use was smaller among men in urban areas compared to rural areas in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 2.1 (95% CI: 1.67-2.73), compared to 1.6 (95% CI: (1.31-1.95). In both countries, prevalence of tobacco use was higher in men who are traditionalist/spiritualists or who had no religion compared to Christians, although the association was stronger in Ghana. The AOR in Ghana is 6.2 (95% CI: (4.42-4.09) compared to 1.7 (95% CI: (1.21-2.47). The prevalence of tobacco use was low among men with richest wealth status compared to men with poorest wealth status in both Ghana and Lesotho, although the association is weaker in Ghana. The AOR in Ghana is 0.1 (95% Cl: (0.06-0.17) compared to 0.4 (95% CI: (0.51-1.12). In relation to occupation, prevalence of tobacco use was smaller among professional workers compared to men in the Agricultural sector in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 9.3 (95% Cl: (4.54-18.99), compared to 3.5 (95% CI: (2.27-5.52). Formerly married men in both countries were more likely to use tobacco compared to currently not married men, although the prevalence was higher in Ghana. The AOR in Ghana is 1.6 (95% CI: (0.99-2.28)], compared to 1.4 (95% CI: (0.89-2.28) in Lesotho.
Although similar socio-economic inequality factors provided an understanding of tobacco use among men in Ghana and Lesotho, there were variations in relation to how each factor influences tobacco use.
烟草使用是可预防死亡的主要原因之一，已成为一个重大的公共卫生问题。以往的研究较少关注发展中国家男性的烟草使用情况和社会经济平等问题。本研究探讨了加纳和莱索托男性烟草使用与社会经济不平等之间的关系。
本研究利用了来自加纳和莱索托2014年人口与健康调查（DHS）的数据。采用二元逻辑回归分析来研究受访者的社会经济不平等特征与烟草使用之间的关联。
结果显示，莱索托的烟草使用率（47.9%）高于加纳（6.3%）。莱索托所有年龄组的烟草使用率普遍较高，相比之下，加纳各年龄段的烟草使用率相对较低。在这两个国家，所有社会经济变量与烟草使用之间均存在统计学上的显著关联。在加纳和莱索托，15 - 24岁年龄组的烟草使用率低于25 - 34岁和35 - 59岁年龄组，尽管在加纳这种关联更强。加纳的调整后比值比（AOR）分别为5.3（95%置信区间：3.29 - 8.59）和9.7（95%置信区间：6.20 - 15.06），而莱索托分别为1.7（95%置信区间：1.32 - 2.11）和1.7（95%置信区间：1.36 - 2.12）。在加纳和莱索托，受教育程度较高的男性吸烟率低于未受过教育的男性，尽管在加纳这种关联较弱。加纳的AOR为0.1（95%置信区间：(0.02 - 0.11)），而莱索托为0.2（95%置信区间：(0.17 - 0.30)）。在加纳和莱索托，城市地区男性的烟草使用率低于农村地区男性，尽管在加纳这种关联更强。加纳的AOR为2.1（95%置信区间：1.67 - 2.73），而莱索托为1.6（95%置信区间：(1.31 - 1.95)）。在这两个国家，传统主义者/唯灵论者或无宗教信仰的男性比基督教男性的烟草使用率更高，尽管在加纳这种关联更强。加纳的AOR为6.2（95%置信区间：(4.42 - 4.09)），而莱索托为1.7（95%置信区间：(1.21 - 2.47)）。在加纳和莱索托，最富有财富状况的男性烟草使用率低于最贫穷财富状况的男性，但在加纳这种关联较弱。加纳的AOR为0.1（95%置信区间：(0.06 - 0.17)），而莱索托为0.4（95%置信区间：(0.51 - 1.12)）。关于职业，在加纳和莱索托，专业人员的烟草使用率低于农业部门的男性，尽管在加纳这种关联更强。加纳的AOR为9.3（95%置信区间：(4.54 - 18.99)），而莱索托为3.5（95%置信区间：(2.27 - 5.52)）。在这两个国家，曾经结婚的男性比目前未婚的男性更有可能使用烟草，尽管加纳的患病率更高。加纳的AOR为1.6（95%置信区间：(0.99 - 2.28)]），而莱索托为1.4（95%置信区间：(0.89 - 2.28)）。
尽管相似的社会经济不平等因素有助于理解加纳和莱索托男性的烟草使用情况，但每个因素对烟草使用的影响方式存在差异。
